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This is a highly peculiar study in which patients undergoing major abdominal surgery had to abstain from eating 9 days before the operation. To make things worse, they were not fed up to 7 days after the operation. The most important conclusion was that they develop some deficiency in vitamin K dependent coagulation factors, which is not a surprise at all. This reviewer has serious ethical problems with this study (apparently not approved by an ethical review board) which puts patients in an adverse situation and is (sorry to say) scientifically worthless. The fact that, in addition to the 16-day fast, patients may also have lost blood during surgery is not even mentioned. This paper should be forgotten rapidly…

– Marcel Levi